Document Detail


Do General Medical Practice Characteristics Influence the Effectiveness of Smoking Cessation Programs? A Multilevel Analysis.
MedLine Citation:
PMID:  22193573     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: General practice is a recommended setting for the delivery of smoking cessation programs. Little is known about the types of practice that achieve higher cessation rates. To address this gap in knowledge, we assessed the impact of general practice characteristics on the outcomes of a large scale smoking cessation intervention delivered in general practice settings. METHOD: A cross-sectional study was undertaken of 7,778 participants enrolled on a structured cessation program comprising repeated brief interventions in one-to-one sessions and nicotine replacement therapy in Christchurch New Zealand, 2001-2007. We employed a logistic multilevel analysis of respondents nested in general practices with cessation at 6 months as the outcome measure. RESULTS: After taking into account relevant individual-level predictors (age, sex, smoking intensity) and area-level surrogates for individual predictors (socioeconomic status and access to tobacco retail outlets), there remained significant variation in quit rates between practices. This variation reduced when practice characteristics were included. Practices with a majority of male doctors and practices with fewer male patients were associated with better quit rates. Practices with large numbers of doctors were less effective in achieving cessation with heavy smokers.Conclusions:The effectiveness of smoking cessation programs can be influenced significantly by practice characteristics. To increase quit rates, more attention should be paid to the institutional setting of smoking cessation programs. Assessments of the effectiveness of cessation programs should give appropriate recognition to the fact that some practices may find higher quit rates more difficult to achieve.
Authors:
Rosemary Hiscock; Graham Moon; Jamie Pearce; Ross Barnett; Vivien Daley
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-21
Journal Detail:
Title:  Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco     Volume:  -     ISSN:  1469-994X     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815751     Medline TA:  Nicotine Tob Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Corresponding Author: Graham Moon, B.A., Ph.D., Geography and Environment, University of Southampton, Highfield, Southampton SO17 1BJ, UK. Telephone: 44-23-8059-3822; E-mail: g.moon@soton.ac.uk.
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